Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press910.17650/1994-4098-2014-0-1-36-41MAMMOLOGY. TREATMENTМАММОЛОГИЯ. ЛЕЧЕНИЕCurrent approaches to therapy for complications of bone metastases from breast cancerСовременные подходы к терапии осложнений костных метастазов при раке молочной железыZhukovaL. G.ЖуковаЛ. Г.
Russian Federation
zhukova.lyudmila@rambler.ruN.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, MoscowФГБУ «РОНЦ им. Н.Н. Блохина» РАМН, Москва17072014136411707201417072014https://ojrs.abvpress.ru/ojrs/article/view/9

In breast cancer, bone metastases are detectable in more than 60 % of patients. Bone metastasis-related complications (BMRCs), such as chronic pain, immobilization, and pelvic dysfunctions due to spinal cord compression, considerably worsen quality of life in patients. Intra- venous formulations of bisphosphonates (zoledronic acid, pamidronate, ibondronate, and clodronate) could reduce the risk of BMRCs by 16-40 % and increase time to the first skeletal complication up to 12–13 months. However, despite the explicit clinical efficacy of bisphospho- nates, the latter can seemingly prevent only some BMRCs. Denosumab, a fully human monoclonal antibody to RANKL, suppresses the forma- tion and functional activity of osteoclasts, thus inhibiting bone resorption.The results of a registration study have indicated that denosumab is not only as effective as zoledronic acid, but also can reduce the risk of BMRCs and significantly delay time to the first and further skeletal complications, including the need for radiotherapy, the development of hypercalcemia and pathological fractures. Denosumab is an effective, well-tolerated drug that can increase a chance of preventing BMRCs in breast cancer.

При раке молочной железы метастазы в кости выявляются более чем у 60 % больных. Осложнения, связанные с костными мета- стазами (ОКМ) (хроническая боль, иммобилизация и нарушение тазовых функций вследствие компрессии спинного мозга), зна- чимо ухудшают качество жизни больных. Использование внутривенных форм бисфосфонатов (золедроновой кислоты, памидро- ната, ибандроната и клодроната) позволило снизить риск развития ОКМ на 16–40 % и увеличить время до развития первого скелетного осложнения до 12–13 мес. Однако, несмотря на явную клиническую эффективность бисфосфонатов, очевидно, что только часть ОКМ может быть предотвращена благодаря их использованию. Деносумаб – полностью гуманизированное моно- клональное антитело к RANKL – подавляет образование и функциональную активность остеокластов, ингибируя, таким обра- зом, процесс резорбции кости.Результаты регистрационного исследования показали, что деносумаб не только не уступает по эффективности золедроновой кислоте, но и позволяет снизить риск развития и достоверно отсрочить время наступления первого и последующих скелетных осложнений, в том числе необходимости в проведении лучевой терапии, развития гиперкальциемии и патологических переломов. Деносумаб является эффективным хорошо переносимым препаратом, позволяющим увеличить шанс на предотвращение ОКМ при раке молочной железы.

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